Day in the Life: General Surgery

I never thought I’d ever say this, but my General Surgery rotation was a ton of fun! Who woulda thought!? (I was honestly a little depressed on my last day. :[ The ladies at my preceptor’s office threw me a pizza party! :O )

Make no mistake–I’m still gung-ho Family Medicine all the way. Surgery is fun, and I loved that he let me do all sorts of procedures, but it’s not what I want to do for the rest of my life. I just really adored working with my preceptor. :O

I’ll get into that more when I write up my reflections post for this rotation (all other reflections can be found here!), so for now, I’m just gonna say that every day was filled with laughter and jokes, and I looked forward to em’ even though the hours were sometimes super long. :]!

Day In The Life: General Surgery

Feel special, because I very rarely take selfies. >_> You get 2 whole locker room selfies today!

A Typical Day

There is no real “typical” routine day in surgery, so I’m just gonna walk you through one of my Tuesdays, because Tuesdays = my preceptor’s surgery day (aka surgeries all day long)!

Didactics at 7-8 a.m. The hospital I’m at has a Family Medicine residency program, so we go to didactics every morning with all the residents. This includes any of the following:

• Journal Club: Residents and/or students will pick an article on a certain subject/topic and discuss it with us. I did mine on the health benefits of exercise in the elderly. :O
• Grand Rounds: One of the residents will usually present a patient case that they had, and we go through their clinical presentation together. From there, we discuss what labs and imaging studies we’d order, come up with a differential diagnosis, and at the end, the resident reveals what was done for the patient + what their actual diagnosis was.
• M&M (Mortality & Morbidity): Peer reviews on mistakes made during the care of patients, so that we can learn from the errors and prevent making these same mistakes in the future.
• Yale: We’re given journal articles to read + questions to answer at the end of each week, and this is when we discuss the answers!
• Bread & Butter: We go over some kind of common “every day” case or condition.
• OMT: We go over osteopathic manipulations and treatments for different conditions!
• Other: There are sometimes drug rep presentations, or residents/other students will present on special projects/research they’re working on.

8 a.m.-???

After didactics, I walk over to the hospital and meet up with my preceptor in the surgeons’ lounge. (Lately, it’s been super humid in there and it smells like maple syrup, so we escape to the physicians’ lounge whenever we can, also because the latter has food and drinks.)

I change from my outside scrubs to a pair of hospital scrubs, and grab a mask + two dysfunctional shower hats surgical caps (I usually keep my hair in a long ponytail when I’m on my rotations). The first one goes over the ponytail + half my head, and the second one keeps it all in place.

(For the record, I so very much love getting to wear scrubs instead of professional clothing. I haven’t been able to do this since Emergency Medicine + Radiology!)

If I’m feeling super fancy, I put on shoe covers too.

After I scrub in (think lots and lots and lots of thorough + meticulous handwashing), I hipbump the door to the operating room (OR) and one of the nurses helps to gown + glove (size 6!) me. For the surgeries where my preceptor’s using the Da Vinci robot, I watch on the screen and ask and/or answer questions, and keep my hands clasped in front of me so I won’t be a total fail (don’t you dare break that sterile field, Farrah! :O ).

My preceptor lets me do a lot, which I really appreciate. I was closing up patients on my first day in the OR (it was gallbladder day), and he left the room on the second patient I was closing up, so I like to take this to mean that he has at least a little faith in me!

I’ve also gotten to intubate, to place and remove Mediports, cauterize vessels, excise tumors, and make the initial incisions before he starts in with the robot! :] He says I have a great eye for excisional debridements and that I do an amazing job on them, so he lets me do em’ all. :O

After each surgery, we’ll go talk to their family to tell them how the surgery went, and to let them know approximately when they’ll be transferred upstairs, and/or when the patient can go home.

If we have any downtime between surgeries, we round on his patients on the surgical floor to see how they’re all doing, and finish up our notes on them. Otherwise, we see em’ after we’re done with all our surgeries for the day…unless it’s really late and we’re tired beyond reason, in which case we sneak out of the hospital to go home to sleep, and see them several hours later.

Somewhere after anywhere between 6 p.m. to 11 p.m., I head home for the day! When I get home, I’ll usually try to review the things we saw/went over/discussed that day that I didn’t know so that I can ask him about them the next day if I still have questions. My preceptor is super nice, so he sends me home if there’s nothing to teach (while he stays til 3 a.m. or some such inhumane hour to finish up on everything he has to do).

Boards are also coming up again (le sigh), so if there’s time, I try to get through my daily Firecracker questions + do practice questions from my QBank.

Once, I got out super early, so I practiced suture ties on my balcony.

My preceptor has my number for if he gets any sort of super interesting/rare/exciting case in the evening or somewhere through the night. I’ve been called in once earlier on a Friday morning to do an excisional debridement of someone’s foot. He’s a diabetic who stepped on a nail and tried to take care of the wound on his own, but it got wildly infected, and what looked like 0.5 cm x 0.5 cm x 1.6 cm wound ended up being a 9.2 x 3.7 x 3.2 cm wound.

Reason #1242104918 as to why prevention of diabetes is a wonderful idea.

(My weekends are nonexistent sometimes, but the hours are a lot shorter then!)

Meals

Every now and then between cases, we’ll get a spare moment to sneak-powerwalk to the physicians’ lounge to grab lunch.

If my preceptor has a meeting, he drops me off in the lounge so I can eat (my badge unfortunately doesn’t give me access to it :x ) before heading off to the meeting. :]

Parking

Free!

Housing

I’m back at my base site, so I’m living in my apartment in Kentucky, and I have my free gym back again! <3